the face-to-face interviews were conducted by experienced healthcare professionals on three separate occasions following the attack: five months later, 15 months later and 30 months later. participants were asked questions about symptoms of post-traumatic stress syndrome and others intended to reveal feelings of complicated grief, such as those related to difficulty accepting the loss, managing intense grief and coping with thoughts surrounding death.
they found that people who reported symptoms of ptsd were significantly more likely to also relay feelings of complicated grief, with those who still felt the effects of ptsd one year after the attack struggling with the most intense symptoms of this form of grief.
“the fact that we found that ptsd symptoms predicted complicated grief reactions at a subsequent time point, but complicated grief did not predict the development of ptsd, is interesting because it suggests that targeting ptsd symptoms may hinder later development of complicated grief,” glad said. “this may have important implications for clinicians working with bereaved trauma survivors.”
the terrorist attack took a particularly heavy toll on survivors because — in addition to losing loved ones — they were a part of the traumatic event, researchers said. the “dual burden” of unexpected loss combined with high exposure to the event itself may steer ptsd symptoms toward complicated grief in a manner not seen in people who were removed from the violence.